COVID Booster Shot Meets Health Care Monopoly

This post is part of an occasional series on health care. Here’s the prologue to the series, which originally preceded the post below.

Here’s a fairly straightforward story from The New York Times from a few days back, reminding us of the fact that immunity from some of the COVID vaccinations is limited in time, and may well require a booster shot.

 WASHINGTON — Biden administration health officials increasingly think that vulnerable populations will need booster shots even as research continues into how long the coronavirus vaccines remain effective.

Senior officials now say they expect that people who are 65 and older or who have  compromised immune systems will most likely need a third shot from Pfizer-BioNTech or Moderna, two vaccines based on the same technology that have been used to inoculate the vast majority of Americans thus far. That is a sharp shift from just a few weeks ago, when the administration said it thought there was not enough evidence to back boosters yet.

On Thursday, a key official at the Centers for Disease Control and Prevention said  the agency is exploring options to give patients with compromised immune   systems third doses even before regulators broaden the emergency use authorization for coronavirus vaccines, a step that could come soon for the Pfizer    vaccine.

Skipping a bit:

Pfizer’s continuing global study of its clinical trial participants shows that four to six months after the second dose, the vaccine’s effectiveness against symptomatic infection drops from a high of 95 percent to 84 percent, according to the company.

As a (then) full-time hospital worker actively exposed to high concentrations of COVID, I got my second dose of the Pfizer-BioNTech shot on January 6. If the vaccine’s effectiveness definitely drops from 95% to 84% in four to six months, then I’m well past my due date for a booster. Though I’m no longer a full-time hospital worker, I’ve been waiting for twelve weeks now for the paperwork to go through on my bid to work per diem for Hunterdon Medical Center’s OR. Assuming it goes through, I’ll be back in the COVID-intensive environment I previously inhabited. And if it doesn’t go through, I intend to apply to do the same work at a different hospital. So one way or another, I intend to make my way back to hospital work, and (by implication) to re-immerse myself in COVID.

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Health Care: A Series

This was originally a post on COVID booster shots, but I’ve now broken it into two separate posts, the first a prologue offering a very general summary of my approach to issues in health care, and the second, a post expressing skepticism about the need to wait any longer before we roll out a COVID booster, as well as skepticism about monopolistic institutional arrangements (distributive and/or regulatory) in health care.

I work in health care, but have no worked-out view on the political economy of health care. In fact, part of the reason I accepted the (full time) job I currently have, in hospital revenue cycle management, is to clarify my thoughts on that very subject. So I’m open to being schooled on issues in health care by anyone willing and able to do so–a category that probably includes a very large number of people. For the time being, I’m willing to remain at least temporarily in a state of curmudgeonly skepticism, willing to take pot shots at almost everyone, but unwilling to pledge allegiance to much of anything. You might regard that as a frivolous position to take, considering the stakes involved. But I don’t.

Since I’m going to be writing here at PoT about health care a fair bit in the near future (I’ve done some already), take what I say in the preceding skeptical (or dialectical) spirit. My aim is, through discussion and experience, to work my way from skepticism to something more definite.

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Robert Hollander, RIP

Robert Hollander passed away on April 20th of this year, but having just learned the news about a week ago, I wanted, however belatedly, to mark the event. From the official announcement by Princeton University’s Office of Communications:

Robert Hollander, professor of European literature, and French and Italian, emeritus, and renowned scholar of Dante, died peacefully of natural causes at his family’s home in Pau’uilo, Hawaii on April 20. He was 87.

Hollander joined Princeton’s faculty in 1962 and transferred to emeritus status in 2003. His teaching and research centered on medieval Italian literature, with a focus on the work of Dante Alighieri and Giovanni Boccaccio.* 

I took the two-semester “Great Books” course in literature that Hollander co-taught at Princeton in the late 1980s, and it changed my life. The first semester covered Greek and Roman classics, plus the Bible; the second semester began with Dante’s Inferno and ended with Dostoevsky’s The Idiot. I still own the very texts I bought for the course thirty years ago; every work retains its poignancy, and is still in some way indelibly imprinted on my mind.

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Ragnarok Lobster

What do Good Morning America, the Australian Outback, Mary Poppins, David Friedman, Lawrence of Arabia, and a balloon voyage to a lost colony of Vikings at the North Pole have in common? Get the answers in this video, as I take you on a journey BEYOND YOUR IMAGINATION!!!

do the wrong thing?

My last post concerned the Scanlonian contractualist idea that the wrongness of wrong action is constituted by the action not being justifiable to others. I criticized this idea on the grounds that justifying to others presupposes the existence of the justifiability-independent and entailed-by-wrongness (or more specifically partially-wrongness-constituting) normative feature of the action warranting resentment (and hence objection) by the patient — patient-objectionability. I also suggested, in the post and in replies to comments, something of a positive view of wrongness. Specifically, that the wrongness of a wrong action is constituted by the following distinct normative features (and their being tied together in some necessary way): (i) patient-objectionability, (ii) observer-objectionability, (iii) (collective) disallowability and (iv) agent-avoidability (specifically such that the agent ought not and must not perform patient-objectionable actions). That is rough, but adequate for working with. In this post, I want to make some modest proposals regarding agent-avoidability and how this might be tied to patient-objectionability.

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Justify Yourself

According to a family of “contractualist” views of morally wrong action pioneered by Thomas Scanlon (in the narrow sense of ‘wrong’ that entails wronging someone and the victim having claims against one not to perform the action — “what we owe to each other”), what makes an action wrong is that it cannot be justified to others. The appeal of this sort of view is at least twofold. First, it specifies a very intuitive way in which actions are made wrong by the reasons (interests, well-being) of others. Second, it occupies a theoretically appealing “third way” between the utilitarian take on morally wrong action as not-welfare-optimific (or indirectly some function of this) and various Kantian (and related) positions according to which morally wrong actions are a type of action that reason itself forbids us (or that otherwise are irrational or violate rational requirements). The specific formulation of contractualism that Scanlon defends is a bit different (and of necessity more complicated) from the core idea just expressed, but the core idea of justifiability-to-others captures the essence.

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200ProofMath

The latest thinking on economic justice, care of 200ProofLiberals, by Christopher Freiman. Worth comparing and contrasting with our own recent discussions of labor-management relations here at PoT.

Marx writes, “In communist society, where nobody has one exclusive sphere of activity but each can become accomplished in any branch he wishes, society regulates the general production and thus makes it possible for me to do one thing today and another tomorrow, to hunt in the morning, fish in the afternoon, rear cattle in the evening, criticise after dinner, just as I have a mind, without ever becoming hunter, fisherman, herdsman or critic.”

However, by making you significantly richer, a capitalist society does a much better job of enabling you to hunt in the morning and criticize after dinner than a non-capitalist society. Ironically, though, you have to cut way back on your consumption to make this happen. But if you’re willing to save 50-70 percent of your income, there’s a good chance you can retire in your 30s or 40s and spend your time doing whatever you want. So capitalism allows you to achieve the flexibility that Marx dreams of—you just need to buy a lot less (which, if you reject consumer culture, should be pretty easy) and save a lot more.

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Tragedy, Catharsis, and Explanation

In the Internet Encyclopedia of Philosophy entry on Aristotle’s Poetics, Joe Sachs writes (italics mine):

Because the suffering of the tragic figure displays the boundaries of what is human, every tragedy carries the sense of universality. Oedipus or Antigone or Lear or Othello is somehow every one of us, only more so. But the mere mention of these names makes it obvious that they are not generalized characters, but altogether particular. And if we did not feel that they were genuine individuals, they would have no power to engage our emotions. It is by their particularity that they make their marks on us, as though we had encountered them in the flesh. It is only through the particularity of our feelings that our bonds with them emerge. What we care for and cherish makes us pity them and fear for them, and thereby the reverse also happens: our feelings of pity and fear make us recognize what we care for and cherish. When the tragic figure is destroyed it is a piece of ourselves that is lost. Yet we never feel desolation at the end of a tragedy, because what is lost is also, by the very same means, found. I am not trying to make a paradox, but to describe a marvel. It is not so strange that we learn the worth of something by losing it; what is astonishing is what the tragedians are able to achieve by making use of that common experience. They lift it up into a state of wonder.

Though Sachs disclaims the desire to make a paradox, I find his claim curious–neither obviously false nor obviously true, but puzzling to the point of inducing a bit of wonderment. I’m interested to hear what readers think.

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Reason Papers Vol. 42:1 Out

The most recent issue of Reason Papers is out (Summer 2021), now fully under the editorship of Shawn Klein (Philosophy, Arizona State University). The journal has transitioned to a new format of only publishing symposia and book reviews, eliminating the free-standing Articles and Discussion Notes that were once a staple.

This issue features a symposium on Douglas Rasmussen and Douglas Den Uyl’s The Realist Turn: Repositioning Liberalism, with contributions by David Kelley, Aeon Skoble, Timothy Sandefur, Paul Gaffney, and Lauren Hall, and a response by Rassmussen and Den Uyl. Also includes reviews of Eric Mack’s Libertarianism, and Marc Champagne’s Myth, Meaning, and Antifragile Individualism: On the Ideas of Jordan Peterson. Links to the issue below the fold.

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What to the Palestinian is the Fourth of July?

Barely a word about this in the mainstream American media. Barely a word about it from libertarian defenders of property rights. But lots of caterwauling about “cancel culture” and Critical Race Theory, and lots of empty rhetoric about the “freedom” we brought the world with the Revolution of 1776.*

Israel has sent demolition notices to residents of about 100 homes in Silwan, warning their abodes–housing more than 1,500 people–are to be destroyed.

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